1,721,041 research outputs found
Diet as a cornerstone of cardiovascular prevention: the key role of coffee consumption
No full textNo abstract availabl
Hepatitis C virus-related autoimmunity before and after viral clearance: a single center, prospective, observational study
No full textBackground: Hepatitis C virus (HCV) chronic infection is frequently associated to autoimmune manifestations. The aim of this study was to prospectively evaluate the occurrence of clinical and/or laboratory features of autoimmunity in a cohort of 140 consecutive HCV chronically infected patients treated with direct-acting antiviral agents (DAAs) and followed-up for 96 weeks. Methods: All patients were screened for cryoglobulins, rheumatoid factor (RF), C3, C4, antinuclear antibody (ANA), anti-smooth muscle (ASMA), anti-liver kidney microsome type 1 (anti-LKM1), anti-mitochondrial antibodies (AMA), anti-neutrophil cytoplasmic antibodies (ANCA), and anti-liver cytosol type 1/soluble liver antigen (anti-LC1/SLA) autoantibodies before therapy and 12, 48 and 96 weeks after treatment. They were then grouped according to the expression of laboratory findings and related autoimmune diseases. Results: At baseline, autoimmune manifestations were found in 70 patients: 83% of them were cryoglobulinemic, whereas ANA, AMA, perinuclear ANCA (pANCA) and LKM/LC1 autoantibodies were found in the remaining 17%. An autoimmune disease was diagnosed in 9 cases, two of them featuring an autoimmune liver disease (AILD). At the end of follow-up, despite viral clearance and regression of vasculitis, cryoglobulins persisted in 12 patients (21%), and autoantibodies disappeared or decreased in most of cases but, with the exception of the 2 patients diagnosed as AILD, associated autoimmune diseases remained stable. In one patient with relapsing cryoglobulinemia and ANA positivity, type-1 autoimmune hepatitis was defined. Conversely, autoantibodies first appeared after viral clearance in 5 patients, of whom one was diagnosed with type-1 autoimmune hepatitis and one with pANCA+ primary sclerosing cholangitis. Conclusions: Following DAA-induced viral clearance, cryoglobulins may persist or reappear. Autoantibodies changed dynamically in step with the disappearance of a previously diagnosed or the occurrence of a new AILD. A longer follow-up will be necessary to establish the possible diagnosis of a newly onset AILD, the reactivation of cryoglobulinemic vasculitis and even its progression to non-Hodgkin lymphoma
The influence of oxygen supply, hemorheology and microcirculation in the heart and vascular systems
No full textThe microcirculation is an important system, containing resistance arterioles, capillaries and venules, whose main function is to transport oxygen and nutrients to the tissues. Endothelial cells are the main cell types of the microcirculation; their homeostasis is modulated by constant shear stress. Altered hemorheology induces a change in the production of vasodilator and vasoconstrictor agents. The most important pattern inducing endothelium dysfunction is an increase in oxidative stress, which decreases the amount of nitric oxide and favors microvascular phlogosis. In this review we will consider the main scientific reports about the cardiovascular risk factors such as smoking, hypercholesterolemia, hyperviscosity, hypertension, diabetes, stress and increased homocysteine levels, all having as common etiopathogenetic factor alterations in microcirculation and in tissue oxygenation. We also focus on their influence on endothelial cells, inducing endothelial changes and dysfunction related to altered oxygen supply and linked to increased oxidative stress. Also important are endothelial stem cells, that are able to repair vascular endothelial damage, especially in cardiovascular patients, with or without endothelial dysfunction. Under these circumstances the numbers of these stem cells are altered, which means there is a decrease in regeneration capability (post ischaemia modified albumin, etc.). This could be an important negative prognostic factor. Microcirculation and tissue oxygenation are very important factors strongly linked to hemorheology, especially in cardiovascular patients, and their alterations could cause impairment, or initiate cardiovascular pathologies. © Springer Science+Business Media, LLC 2010
Echocardiography in preliminary evaluation of pulmonary hypertension: comparison of echographic parameters and two scores in real life experience.
No full textThe Most Severe Paradigm of Early Cardiovascular Disease: Hutchinson-Gilford Progeria. Focus on the Role of Oxidative Stress
No full textOxidative stress (OS) is one of the most frequently recognized causes of ageing. Telomere erosion, defects in the DNA damage response and alterations in the nuclear architecture are also associated with premature ageing. The most severe premature ageing syndrome, Hutchinson-Gilford progeria syndrome (HGPS) is associated with alterations in nuclear shape resulting in the deregulation of lamin A/C. In this review we describe emerging data reporting the role of OS and antioxidant defence in progeroid syndromes focusing on HGPS. We explore precise antioxidant defence mechanisms and related drugs that may create a potential path out of the woods in this disease. Pathways regulated by Nuclear factor E2 related factor (Nrf2), by Nuclear Factor kappa B (NF-kB), and related to the Unfolded Protein Response (UPR) and Endoplasmic Reticulum (ER) stress are under investigation in HGPS patients for which the goal is a significant lifespan extension in particular by postponing atherosclerosis-related complications
Neutrophil Extracellular Traps (NETs) and Damage-Associated Molecular Patterns (DAMPs): Two Potential Targets for COVID-19 Treatment
Full text linkCOVID-19 is a pandemic disease caused by the new coronavirus SARS-CoV-2 that mostly affects the respiratory system. The consequent inflammation is not able to clear viruses. The persistent excessive inflammatory response can build up a clinical picture that is very difficult to manage and potentially fatal. Modulating the immune response plays a key role in fighting the disease. One of the main defence systems is the activation of neutrophils that release neutrophil extracellular traps (NETs) under the stimulus of autophagy. Various molecules can induce NETosis and autophagy; some potent activators are damage-associated molecular patterns (DAMPs) and, in particular, the high-mobility group box 1 (HMGB1). This molecule is released by damaged lung cells and can induce a robust innate immunity response. The increase in HMGB1 and NETosis could lead to sustained inflammation due to SARS-CoV-2 infection. Therefore, blocking these molecules might be useful in COVID-19 treatment and should be further studied in the context of targeted therapy
Spotlight on Cardiovascular Scoring Systems in Covid-19: Severity Correlations in Real-world Setting
No full textObjectives and Methods: the current understanding of the interplay between cardiovascular (CV) risk and Covid-19 is grossly inadequate. CV risk-prediction models are used to identify and treat high risk populations and to communicate risk effectively. These tools are unexplored in Covid-19. The main objective is to evaluate the association between CV scoring systems and chest X ray (CXR) examination (in terms of severity of lung involvement) in 50 Italian Covid-19 patients. Results only the Framingham Risk Score (FRS) was applicable to all patients. The Atherosclerotic Cardiovascular Disease Score (ASCVD) was applicable to half. 62% of patients were classified as high risk according to FRS and 41% according to ASCVD. Patients who died had all a higher FRS compared to survivors. They were all hypertensive. FRS30 patients had a 9.7 higher probability of dying compared to patients with a lower FRS. We found a strong correlation between CXR severity and FRS and ASCVD (P < 0.001). High CV risk patients had consolidations more frequently. CXR severity was significantly associated with hypertension and diabetes. 71% of hypertensive patients’ CXR and 88% of diabetic patients’ CXR had consolidations. Patients with diabetes or hypertension had 8 times greater risk of having consolidations. Conclusions: High CV risk correlates with more severe CXR pattern and death. Diabetes and hypertension are associated with more severe CXR. FRS offers more predictive utility and fits best to our cohort. These findings may have implications for clinical practice and for the identification of highrisk groups to be targeted for the vaccine precedence
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